scholarly journals PATHOMORPHOLOGY OF FIBROSING PROCESSES IN THE LIVER AND LUNGS IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS AND OBESITY AT COMORBIDITY WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
O.Ye. Hryniuk ◽  
I.S. Davydenko ◽  
O.S. Khukhlina ◽  
A.A. Antoniv ◽  
V.S. Haidychuk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Connective Tissue ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Specific Volume ◽  
Liver Parenchyma ◽  
Collagen Fibers ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Steatohepatitis

Objective - to study the histochemical and histological features of the liver and lungtissues in patients with non-alcoholic steatohepatitis (NASH) and obesity under conditionof a comorbid course with chronic obstructive pulmonary disease (COPD).Material and methods. The autopsy material of 27 cases with NASH, including 13 casesof NASH and obesity of I degree (group 1), 14 cases of NASH, obesity of I degree withcomorbid COPD of II-III stage (group 2) was used. The groups of comparison includedautopsy material of 12 patients with isolated COPD of II-III stage (Group 3), as wellas 11 practically healthy persons (PHP), their main causes of death were polytraumaor traumatic brain injury or sudden coronary death. The groups were randomizedaccording to age, sex, degree of obesity. The average age of patients was (59,3 ± 3,21)years.Results. The volume of the connective tissue (CT) in the liver parenchyma in the 2nd groupwas in 1,9 times higher than in the 1st group (p<0,05), the specific volume of collagenfibers in 1,4 times, the optical density of collagen fibers by 1,2 times (p<0,05). In the 2ndgroup, the maximum damage to the respiratory parts of the lungs (RPL) was establishedin terms of percentage of filling of the RPL spaces with desquamated cells (in 9.4 times incomparison with PHP, by 1,3 times compared to the indicator in the 3rd group); specificvolume growth of the blood vessels in the peribronchial CT by 1,4 times (p<0,05). Thephenomena of venous thrombosis are most pronounced both in the peribronchial CT(they exceed the indicator in the 3rd group by 1,2 times) and respiratory parts of the lungs(by 2,4 times) (p<0,05). Patients of the 2nd group had the highest values of the specificvolume of CT in the lungs among all groups under study (19,8 ± 0,37 (p <0,05)).Conclusions. The comorbidity of COPD in patients with NASH and obesity contributedto the higher degree of activation of the connective tissue components in the liverparenchyma in comparison with the NASH indicators against a background of obesitywithout COPD, with an increase in the volume of the connective tissue (in 1,9 times,p<0,05), specific volume collagen fibers (by 1,4 times, p<0,05), optical density ofcollagen fibers coloring (in 1,2 times, p<0,05).

scholarly journals DIAGNOSTIC CAPABILITIES OF DIGITAL FLUOROGRAPHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2015 ◽  
Vol 14 (1) ◽  
pp. 24-31
Author(s):  
N. A. Gorbunov ◽  
A. P. Dergilev ◽  
L. D. Sidorova ◽  
V. I. Kochura
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Stage I ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Mean Values ◽  
Digital Chest ◽  
The Mean

The purpose of the study – to examine the capabilities of the method of digital chest fluorography in diagnosis of chronic obstructive pulmonary disease (COPD) of different stages. By chest digital fluorography 247 patients with clinically diagnosed COPD stage I–III were examined. The average age of the patients was (55.3  1.7) years (16 to 88 years), forced expiration volume for the first second (FEV1) was (59.17  16.28) %. It was shown that for patients with COPD stage I most characteristic radiographic symptom was emphysema of the lung in the upper regions (26 (48%) of 54 patients); the mean values of the inspiratory lung optical density (ILOD) ranged from (703.48  2.15) to (807.47  5.61) optical density units (ODU), the expiratory lung optical density (ELOD) – from (786.05  6.15) to (830.23  4.71) ODU. For patients with COPD stage II the most common radiographic sign was the presence of amplification and deformation pulmonary pattern (95 (89%) of 107 patients); the mean values of ILOD ranged from (646.20  4.94) to (791.38  2.81) ODU, ELOD – from (677.34  9.91) to (813.91  3.29) ODU. Patients with COPD stage III were characterized by a combination of amplification and deformation pulmonary pattern (77 (90%) of 86 patients) with lung emphysema (51 (59%) of 86 patients); the mean values of the inspiratory lung optical density ranged from (765.93  16.4) to (863.37  15.83) ODU, expiratory lung optical density – from (826.80  11.64) to (881.37  4.29) ODU. Thus, we concluded that the method of digital chest fluorography, possessing low dose burden to the patient, can detect the characteristic radiological symptoms and determine the stage of the disease up to the values of the lung optical density in patients with COPD.

Clinical efficacy of hepatoprotector in the complex therapy of non-alcoholic steatohepatitis against the background of obesity for comorbidity with chronic obstructive pulmonary disease

2021 ◽  
Author(s):  
O. S. Khukhlina ◽  
O. Ye. Hryniuk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Liver Steatosis ◽  
Subjective Assessment ◽  
Main Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Steatohepatitis ◽  
Complex Therapy

Objective — to establish the Antral efficacy in terms its effects on the intensity of clinical and biochemical syndromes of non‑alcoholic steatohepatitis (NASH) against the background of obesity at comorbidity with chronic obstructive pulmonary disease (COPD). Materials and methods. The examinations involved 65 NASH patients with I degree obesity and COPD 2 — 3 D. The patients were divided into two groups: 32 patients control groups received NASH therapy (Essentiale forte N (Sanofi Avensis/Nutterman and Cie GmbH) 300 mg, 2 caps., 3 times per day) for 30 days and basic COPD therapy. The second, main group consisted of 33 NASH patients with I degree obesity and COPD 2 — 3 D, who along with the basic therapy for COPD received hepatoprotector Antral (Farmak, Ukraine) 200 mg, 3 times daily for 30 days. The mean age of the patients was 56.3 ± 3.21 years. The comparison group consisted of 30 apparently healthy people (AHP). The values of 30 practically healthy individuals were used as reference. Results. According to the scale of subjective assessment of the intensity of asthenia after treatment in patients of the main group, the effectiveness of its elimination was 3.9 times higher than that of patients in the control group (relative risk 3.87; 95 % CI [1.16 — 12.91], p < 0.05). The manifestations of dyspepsia disappeared faster in the patients of the main group. The use of antral 3.7 times more influenced the manifestations of cholestasis (p < 0.05). Body mass index (BMI) > 32 kg/m2 after treatment, which included a hypocaloric diet and Antral, remained in 13 patients in the main group (39.4 %) versus 29 patients in control group (90.6 %) (p < 0.05). During one month after the treatment, markers of cytolysis remained in 9 patients in control group (28.1 %), and in 1 patient of the main group (3.0 %) (OR 9.28; 95 % CI [1.11 — 77, 52], p < 0.05). The increased activity of cholestasis markers after treatment remained only in 5 patients in the main group (15.2 %) in comparison with 22 (68.8 %) controls. In the dynamics of treatment of patients in the main group, significant increase in the protein‑synthesizing function of the liver was revealed (albumin levels increased by 30.56 % (p < 0.05) relative to the indicator in the control group). Conclusions. The use of Antral in the complex therapy of NASH of patients with the concomitant obesity and COPD was more effective than standard therapy in terms of removal of clinical NASH syndromes: asthenic‑vegetative, dyspepsia, abdominal discomfort, cholestasis, hepatomegaly, degree of liver steatosis; biochemical syndromes: cytolysis, cholestasis, mesenchymal inflammation, hepatocellular failure.  

scholarly journals OPPORTUNITIES OF LOW-DOSE DIGITAL FLUOROGRAPHY IN DIAGNOSIS OF PHENOTYPIC VARIANTS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2018 ◽  
Vol 99 (4) ◽  
pp. 191-196
Author(s):  
N. A. Gorbunov ◽  
A. P. Dergilev ◽  
V. I. Kochura ◽  
Ya. L. Manakova ◽  
S. N. Volchenko ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Differential Diagnosis ◽  
Pulmonary Disease ◽  
Optical Density ◽  
Low Dose ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
X Ray ◽  
Average Value ◽  
Lung Emphysema

Objective. To determine the opportunities of low-dose digital fluorography (LDDF) in differential diagnosis of phenotypic variants of chronic obstructive pulmonary disease (COPD).Material and methods. There were 107 patients with clinically diagnosed COPD of varying severity examined. The average age of the patients was 51.8±1.5 years (46–59 years). All patients for LDDF of the chest in the frontal projection in the inspiratory and expiratory phase of respiration were undergone.Results. The electron optical density of the lungs was determined in the upper, middle and lower zones of both lungs. As a result in patients with a predominance of emphysematous variant of COPD (n=15) the most characteristic radiological symptom was lung hyperventilation (14% of 107 patients) and inspiratory electron optical density value was 748.18±4.72 optical density units (ODU). In patients with a predominance of bronchitic variant of COPD (n=43) the most common radiological symptom was the presence of symptom amplification and deformation of lung pattern (40% of 107 patients) and inspiratory electron optical density value was 668.04±12.26 ODU. For patients with mixed phenotypic variant of COPD (n=49) it was characterized by a combination of X-ray symptom amplification and deformation of lung pattern with lung emphysema (46% of 107 patients); the average value of inspiratory electron optical density value was 815.24±17.25 ODU.Conclusion. The technique of LDDF can detect X-ray symptoms and determine inspiratory and expiratory electron optical density of the lungs in patients with COPD that allows optimizing the differential diagnosis of phenotypic variants of chronic obstructive pulmonary disease.

scholarly journals The influence of basic treatment with tiotropium bromide of patients with chronic obstructive pulmonary disease stage II on the morpho-functional state of bronchial mucosa and the level of type IV collagen in bronchoalveolar lavage fluid.

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Mykola Osyrovskyy ◽  
Mariana Olegivna Kulynych-Miskiv ◽  
Iryna Savelikhina ◽  
Valentina Goncharuk ◽  
Ksenia Ostrovska
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Connective Tissue ◽  
Pulmonary Disease ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Stage Ii ◽  
Tiotropium Bromide ◽  
Chronic Obstructive ◽  
Bronchial Mucosa ◽  
Obstructive Pulmonary Disease

The objective of the research was to evaluate the influence of basic treatment of patients with chronic obstructive pulmonary disease with tiotropium bromide on the processes of morphological rearrangement and local barrier defence mechanisms in the bronchial mucosa.          Stage II chronic obstructive pulmonary disease is associated with the damage to the bronchi with proliferation of the connective tissue in its proper plate, clear identification of the basal membrane alteration, the presence of fibroblasts, the activation of fibroblasts/myofibroblasts and mucous glands, which is accompanied by the significant increase of type ІV collagen levels by 6.19 times (p<0.05) in bronchoalveolar lavage fluid as compared to the control group indices.          The elimination of stage II chronic obstructive pulmonary disease exacerbation and the use of tiotropium bromide within a month was accompanied only by partial improvement of morpho-functional state in relation to both cells of bronchial epithelial lining and adjacent connective tissue of mucosal plate. The prolongation of tiotropium bromide administration from 2 to 6 months, provided positive dynamics of structural morphological changes of the bronchial mucosa (the restoration of the ciliary apparatus of epithelial cells, the normalization of the secretory function of goblet cells, the inactivation of fibroblasts, the initial degeneration of myofibroblasts), thus leading to complete absence of morphological signs of edema or epithelial cell dystrophy.          Conclusions. In patients with stage II chronic obstructive pulmonary disease, complete absence of morphological signs of edema or dystrophy of epithelial cells, against the background of collagenolysis in the connective tissue of the proper mucous plate of the bronchi and the highest possible decrease in the number of myofibroblasts, with near-complete levels of type IV collagen normalization in the bronchoalveolar lavage fluid, were identified only within a 6-month treatment with tiotropium bromide.

Plasma proteolytic and fibrinolytic activity in non-alcoholic steatohepatitis, combined with chronic obstructive pulmonary disease

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
T. P. Tsyntar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Molecular Weight ◽  
High Molecular Weight ◽  
Pulmonary Disease ◽  
Fibrinolytic Activity ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Alcoholic Steatohepatitis ◽  
Α2 Macroglobulin ◽  
High Molecular Weight Proteins

The study involved 30 patients with NASH, 30 patients with chronic obstructive pulmonary disease and 30 patients with non-alcoholic steatohepatitis in combination with chronic obstructive pulmonary disease. A substantial enhancement of proteolysis low and high molecular weight proteins, of colagenolytic activity of plasma and nonenzymatic fibrinolysis against reduction of content of α2-macroglobulin in serum and more pronounced decrease in activity of the enzymatic fibrinolysis in this combined pathology.

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